两种不同头臼匹配的陶瓷人工全髋关节置换术的应用体会及中远期随访  

Application experience and mid-long-term follow-up of ceramic-on-polyethlene bearing surfaces and ceramic-on-ceramic bearing surfaces in total hip arthroplasty

作　　者：张玉舰[1] 郭月超[1] 文立成[2] 

机构地区：[1]河北省秦皇岛市第一医院骨一科,066000 [2]北京大学第一附属医院关节科

出　　处：《山西医药杂志》2015年第12期1348-1351,共4页Shanxi Medical Journal

基　　金：河北省秦皇岛市级科研项目(2007055)

摘　　要：目的：探讨不同头臼匹配的陶瓷人工全髋关节置换术后的中远期疗效。方法自2002—2012年共随访了56例（72髋）半陶全髋关节和全陶瓷髋关节置换术治疗各类髋关节疾病的患者,其中陶瓷头对聚乙烯35髋,陶瓷对陶瓷37髋。术后平均随访（6.0±2.7）年（5-10年）,术后对患者进行 X线片检查并进行对比。结果陶瓷头对聚乙烯组随访的35髋中有5例出现髋臼周围少量骨溶解,2例患者股骨假体近段出现透亮带,偏离中心者1例（1 mm）,但患者均无自觉症状,无一例出现翻修。陶瓷头对陶瓷组影像学表现、骨盆和关节置换的 X线片显示头部无任何方向的脱出（也没有颗粒性骨折溶解）。在髋臼顶部的 CT图像中,将手术侧与非手术侧进行了比较。结果全部病例骨结构正常,无骨质溶解和无骨外囊肿。结论应用陶瓷头对陶瓷和陶瓷头对聚乙烯人工全髋关节置换术后随访患者均无明显骨溶解性颗粒产生,半陶瓷关节置换的患者虽然假体周围出现透亮带,但患者10年随访无症状,无松动及翻修。Objective To probe the mid-long-term clinical efficacy of ceramic-on-polyethlene bearing sur-faces and ceramic-on-ceramic bearing surfaces in total hip arthroplasty.Methods Fifty-six consecutive patients （72 hips）,who underwent primary total hip arthroplasty using ceramic femoral head and polyethlene acetabular liner or ceramic femoral head and ceramic femoral acetabular liner,were enrolled.The examples of ceramic-on-poly-ethlene is 35,and the ceramic-on-ceramic is 37.The average follow-up period were （6.0±2.7）years （ranged 5-10 years）.Radiographic assessment was carried out postoperatively using the X-ray film analysis and CT scan.Results 〈br〉 In the 35 cases of ceramic-on-polyethlene,5 cases were observed with a few osteolysis around acetabulum,and 2 cases with radiolucent lines around the proximal prosthesis,1 femoral head displaced （1 mm）,no subj ective symp-toms and revision operation.In the ceramic-on-ceramic group,no imaging abnormalities were found.We compared operated side with non-operated side of all cases in two groups by scaning the acetabular crest with CT,and that the structures were nomoral, no osteolysis and bone cyst were found.Conclusion Ceramic-on-ceramic bearing systems seemed to produce less wear debris than ceramic-on-polyethlene bearing systems.No osteolysis,wear or fusion signs are detected in ceramic-on-ceramic bearing group among （6.0±2.7）years follow-up.Ceramic-on-ce-ramic bearing components have lower wear rate and the better durability,the clinical results were satisfactory.

关 键 词：关节成形术 置换 髋 陶瓷对陶瓷 陶瓷对聚乙烯 

分 类 号：R687.4[医药卫生—骨科学]